Provider Demographics
NPI:1336412881
Name:WEAVER, BRIDGETT MURTAGH (DPT)
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:MURTAGH
Last Name:WEAVER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIDGETT
Other - Middle Name:ILENE
Other - Last Name:MURTAGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:516 MOUNTAIN AVE
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-1848
Mailing Address - Country:US
Mailing Address - Phone:970-581-1185
Mailing Address - Fax:970-532-7500
Practice Address - Street 1:516 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513
Practice Address - Country:US
Practice Address - Phone:970-581-1185
Practice Address - Fax:970-532-7500
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist